Planning Your Interoperability Strategy? Don't Overlook Provider Data

Healthcare data interoperability initiatives have a long history of health systems, vendors and governments working together to drive improvements in usability, portability and applicability of patient data. Just making this data interoperable isn’t the end goal, though. The real objective is to use that data to make more informed decisions that support more seamless care coordination, effective care delivery and improved patient empowerment. However, provider data hasn't received a commensurate amount of attention and effort, leaving that data fragmented, under-managed and under-leveraged.

While there are many components, technology-driven and not, necessary to improve health outcomes, a clear need is to enhance patient-provider matching. This would ensure that patients are routed to the providers who can best address their unique clinical needs and also align with other important matching criteria for patients (insurance, location, appointment availability and so on). Healthcare organizations have to empower those who make the matches (consumers, access center agents, providers and others) with data that are well-curated, comprehensive, accurate and consistent across health system access points.

Quality provider data consist of much more than name, address and high-level specialty, though. In addition to being accurate, the information needs to be comprehensive, providing a detailed representation of the clinical capabilities of each provider, insight into their philosophies of care, patient feedback, clear practice location information and a host of other critical information.

Making this data “interoperable” — in other words, actionable and leverageable across the enterprise — starts with building a central point of access to the information. As provider data are generally stored in disparate systems throughout an enterprise, centralizing it and implementing an effective data governance model are necessary to ensure accuracy and support ongoing management and curation. Building a robust, enterprise-wide provider directory is a foundational step as health systems seek to enhance patient access across channels to attract new patients, convert demand into (appropriate) booked appointments and retain patients whenever they make care transitions.

Having this rich provider data interoperable across the enterprise means that health systems can empower professionals who help patients find providers, and the patients themselves, identify the right match with their clinical needs, personal preferences, level of acuity and appointment type. Ultimately, once there is an enterprise-wide directory, it must be easily searchable across the network for matching based on a wide range of criteria in a user-friendly way. Thus, no matter who is searching or where they’re searching, they are matching based on detailed, robust information, ultimately facilitating better matches and better outcomes. The ability to then track and analyze patient demand against provider clinical areas of focus and capacity — demand coming in across digital, access center or distributed point-of-service entry points — allows health systems to better optimize their networks and care site offerings.

Achieving the goals of interoperability efforts requires a more detailed understanding of both those who seek care and those who provide it. Improving patient-provider matching to drive better outcomes, along with patient and provider satisfaction, requires looking at both sides of the equation in a way that is both comprehensive and sustainable. Only by looking at these in tandem can we meaningfully accelerate progress toward meeting the objectives of interoperability.

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